Abstract

This study examines the professionalisation strategies of British podiatry between 1960 and 1997, following the introduction of state registration as a pre-requisite for NHS employment. It is primarily concerned with relations within podiatry and between podiatry, medicine and the state. Analyses of these relationships are mainly informed by the Weberian concepts of social closure, professional dominance and autonomy. The major changes, opportunities and challenges to professional development in podiatry in the post-registration era are mapped in thematic and chronological sequence.
Qualitative methods of data collection and analysis have been used to provide detail and depth in presenting a picture of the issues under investigation. Data was primarily collected from 27 key informant interviews supported with documentary evidence from both published material in the public domain and unpublished material in private possession. These consisted of documents derived mainly from primary and inadvertent sources.
Reported efforts by the state registered sector to secure state support for the exclusion of unregistered competitors from practice or to prevent their use of common professional titles failed as a result of government opposition to professional monopolisation and its concern to meet the manpower demands of an expanding NHS podiatry provision.
Despite advances in technology which have facilitated an expansion of role boundaries into the arena of invasive surgical practice and NHS reforms which have permitted its integration into the mainstream health service, traditional podiatric NHS practice now appears increasingly vulnerable to service rationalizations. Encroachment into other areas of medical and radiographic practice have led to inter-professional conflicts which currently remain unresolved, although medical dominance appears intact.
This study suggests that any further podiatric role boundary expansion without medical approval or delegation is unlikely, as is amending legislation to establish a trade monopoly in the provision of footcare services.